Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1033627963 |
---|---|
Provider Name | Jan Michael Llanda |
First Address | North Chesterfield, VA 23225-6972 |
Second Address | North Chesterfield, VA 23225-6972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2018 |
Last Update Date | 16/02/2021 |